Wednesday, July 22, 2020

A peculiar syndrome

I mentioned the odd Indian/Chinese idea about the magical, health giving power of men not letting their semen ever leave their bodies again in a recent post, and have now found out something else that sometimes happens as a result of this belief.

First, a magazine article about some Western dudes who have cottoned onto the idea as a way of trying to make a buck:   The Cult of Semen Retention.   It's pretty amusing, the overblown claims.

But Googling the topic also brings up this topic:  Dhat Syndrome.  As explained in the Indian Journal of Psychiatry:
Dhat syndrome (“semen loss”-related psychological distress) is a culture-bound syndrome seen in the natives of Indian subcontinent, but it is prevalent in other cultures also. Its diagnosis and management issues need to be taught to postgraduates in their teaching program. This syndrome involves vague and multiple somatic and psychological complaints such as fatigue, listlessness, loss of appetite, lack of physical strength, poor concentration, forgetfulness and other vague somatic troubles. These symptoms are usually associated with an anxious and dysphoric mood state. These patients may also present with or without psychosexual dysfunction. The management of Dhat syndrome needs serious attention.
And more details.  First, this is why (some) Indians think semen is so important for health:
Since then, myth prevalent among people of the Indian subcontinent is that “it takes 40 days for 40 drops of food to be converted to one drop of blood, 40 drops of blood to make one drop of bone marrow and 40 drops of bone marrow form one drop of semen.”

You would have thought human biology being a subject in schools would help, but I don't know.

The author then goes on to draw a wider net, alleging that anti-masturbation crusades in Western countries in the past reflects the same sort of attitude.   It partly does, but still, this Dhat Syndrome is something else:
The patients who presented with symptoms of Dhat syndrome were mostly young, recently married, belonging to average or low socioeconomic status (perhaps a student, laborer or farmer by occupation), from rural area and from family with conservative attitudes towards sex.[,,]

Patients having Dhat syndrome can be further divided into three categories.[]
  1. Dhat alone - Patients attributed their symptoms to semen loss; presenting symptoms - hypochondriacal, depressive or anxiety symptoms
  2. Dhat with comorbid depression and anxiety - Dhat was seen as an accompanying symptom
  3. Dhat with sexual dysfunction
The duration of presentation of these patients from the onset varies from less than three months up to one year,[,] even up to 20 years.[] These patients reported that they lose their semen in sleep, with urine, masturbation, hetero/homosexual sex.[,,,]
In other words, it seems that their belief in the health enhancing importance of semen is so strong that even having a young man having sex within marriage can freak out that it's harming him.  As I say, pretty peculiar.

The syndrome even has a Wikipedia entry.  But here is another, better backgrounder about it (from the Indian Journal of Dermatology, for some reason): 
Ayurvedic literature describing semen as a vital constituent of the human body dates back to 1500 BC. The disorders of ‘Dhatus’ have been elucidated in the Charak Samhita, which describes a disorder called ‘Shukrameha’ in which there is a passage of semen in the urine. Similar conditions have been described under various names from China (Shen K'uei), Sri Lanka (Prameha) and other parts of South East Asia (Jiryan). Malhotra and Wig called ‘Dhat’ ‘a sexual neurosis of the Orient’.[] In China, anxiety following semen loss (Shen-K'uie) has been associated with epidemics of Koro, which is another culture bound syndrome in which the individual holds the belief that his penis is shrinking into his body and disappearing. Tissot's paper in 18th century stating that even an adequate diet could waste away through seminal emission gained popularity amongst the emerging middle class and led Western Europe to an era of masturbating insanity.

The International Classification of diseases ICD-10 classifies Dhat syndrome as both a neurotic disorder (code F48.8) and a culture specific disorder (Annexe 2) caused by ‘undue concern about the debilitating effects of the passage of semen.’ It is a commonly recognized clinical entity in India and South East Asia and is also widespread in Nepal, Sri Lanka, Bangladesh and Pakistan.

Dhat Syndrome is characterized primarily with complaints of loss of semen through urine, nocturnal emission or masturbation, accompanied by vague symptoms of weakness, fatigue, palpitation and sleeplessness. The condition has no organic etiology. It may sometimes be associated with sexual dysfunction (impotence and premature ejaculation) and psychiatric illness (depression, anxiety neurosis or phobia).[]
So, there you go.   I feel like drawing up a map sometimes of "bad cultural ideas that are harmful and need to go away", with China being labelled for Traditional Chinese Medicine as my first target.  But the semen worrying seems to me to be more likely Indian in origin. 

Update:  I was curious to read what a Ayurvdic practitioner might say about the condition, and found this site which seems to take a semi sensible line that a lot of anxiety about it is unfounded, but also includes this very specific opinion:

Charaka Samhita postulates that semen is all-pervasive within the body like "oil in the sesamic seed" and suggests one ejaculation per week in summer and 168 total yearly ejaculations as the optimal sexual frequency for males.

But, but...once a week in (say) a 3 month summer would only be about 12 times.   They have a fair bit of catching up to do to hit that weirdly specific "optimal sexual frequency" over the rest of the year.


1 comment:

GMB said...

Well you know what I say. Its pretty crazy in the modern context, unless you are addicted to porn. But it may have had a real functional point to it where zinc was pretty low in the diet. We really need to be cultivating more brackish water areas for oyster production. Oysters compete with liver and egg yolks for the most nutritious foodstuff out there. Shellfish more generally may have had an important role in some stages of our evolution. But every time I go to buy fresh oysters I marvel at how expensive they are. Sometimes you can get half price specials on the cans. What is not generally known, particularly in the context of the pandemic, is just how difficult it is to actually get the zinc into the cell where it will cut off viral replication. The Zn++ ion will naturally be repelled by the fatty acid surface. Insufficient copper and/or stomach acid will also inhibit zinc absorption. Proton pump inhibitors are one of the great killers out there at the moment. Keep taking your Nexium and you are finished over time.